Craig Alexander, Toouli James
Gastrointestinal Surgical Unit, Department of Surgery, Flinders Medical Centre, Bedford Park, Adelaide, South Australia, 5042, Australia.
Curr Gastroenterol Rep. 2002 Apr;4(2):172-6. doi: 10.1007/s11894-002-0056-5.
If the mechanism of pain in patients with sphincter of Oddi (SO) dysfunction is functional obstruction of the biliary tract, and at least in some patients it results from sphincter smooth muscle hypertrophy, then smooth muscle relaxants should have a theoretic role in the management of these patients. Calcium channel antagonists and other smooth muscle relaxants have been shown in "acute" manometric studies to alter SO motility. However, the effect of these agents on vascular smooth muscle remains a concern and often limits their use. At present the role of medical therapy is somewhat unclear because few well-conducted studies have used manometric criteria for the diagnosis of SO dysfunction and the selection of patients for therapy. The main drawback is that no drugs appear to be specific for the SO, long acting, and free of side effects.
如果Oddi括约肌（SO）功能障碍患者的疼痛机制是胆道功能性梗阻，并且至少在部分患者中是由括约肌平滑肌肥大所致，那么平滑肌松弛剂在这些患者的治疗中应具有理论上的作用。钙通道拮抗剂和其他平滑肌松弛剂在“急性”测压研究中已显示可改变SO的运动功能。然而，这些药物对血管平滑肌的影响仍然令人担忧，并且常常限制了它们的使用。目前药物治疗的作用尚有些不明确，因为很少有精心设计的研究使用测压标准来诊断SO功能障碍以及选择治疗患者。主要缺点是似乎没有药物对SO具有特异性、作用持久且无副作用。
